Why carry out this study?

Musculoskeletal (MSK) symptoms, including arthritis and arthralgia, are common manifestations of systemic lupus erythematosus (SLE).

The natural history of SLE has been described in longitudinal cohorts of patients with SLE; however, definitions of the activity patterns have differed across studies and the nature of flaring patterns compared with chronic or quiescent patterns specific to MSK has not been characterized in the literature, nor has it been reported how these patterns impact therapeutic approaches.

The primary objective of this study was to describe the clinical characteristics and treatment patterns of patients with SLE-MSK over time and by disease activity patterns (chronically active, relapsing–remitting, long quiescence) in a 10-year follow-up period from the real-world setting of the Hopkins Lupus Cohort.

What was learned from this study?

This descriptive analysis highlights the impact of prevalent manifestations, such as arthritis on the use of corticosteroids, immunosuppressants, and nonsteroidal anti-inflammatory drugs (NSAIDs) to manage disease activity in patients with SLE. Half of the patients in our analysis presented in an active disease activity pattern, most commonly relapsing–remitting disease activity measured by Safety of Estrogens in Systemic Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index.

The presence of the active patterns (despite high use of combination therapy, corticosteroids, and NSAIDs) suggests there is a need for new therapeutic options to manage disease activity in patients with SLE, permitting better efficacies to be achieved and diminishing the chronic use of these drugs and their long-term side effects.